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Helping Doctors Address Dementia

The American Medical Association has a new guide to help doctors diagnose and treat dementia, which affects millions of people and is becoming an increasing concern as the population ages.

The guide advises physicians on how to tell the difference between types of confusion, whether caused by drugs, say, or normal aging. It includes tests for gauging dementia: asking patients to draw a clock face, identify a pencil and provide the current day, month and year. The guide also recommends ways to prevent and respond to abuse of the elderly.

Dementia is incurable and worsens progressively over the years. Its victims become unable to live independently, since they may have trouble dressing, cooking or finding their way home. Some disregard social rules, with inappropriate remarks or behavior.

Most people with dementia are seen by regular physicians rather than specialists and receive care from family members ''at great physical, psychological and financial cost and burden,'' says the new guide, ''Diagnosis, Management and Treatment of Dementia: A Practical Guide for Primary Care Physicians.''

The guide -- available for $5 a copy, or $3 for A.M.A. members, by calling (312) 464-5563 -- covers treatment and care for the rest of a patient's life. The aims are preventing ''distressing symptoms and behaviors,'' helping ease the burden on family members and avoiding placing people with dementia in institutions prematurely.

''The physician should help the patient function as independently as possible, which minimizes the stress and burden on the caregiver,'' said Dr. Yank Coble Jr., a Florida endocrinologist and a member of the medical association's board. ''Most importantly, the physician should help the family keep their loved one from being institutionalized before he or she really has to be.''